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Ethical and Legal Issues of a Caring-Based Practice Case Study A nurse practitioner (NP) cared for a 21-year-old male at an outpatient clinic. The chief complaints of the 21-year-old with his girlfriend at the time of the visit included a lack of appetite, nausea and vomiting, and some abdominal pain. A urine test revealed hematuria, and the NP diagnosed the patient with viral gastroenteritis. One week later, the patient is transported to the emergency room with a ruptured appendix, requiring immediate surgery. The patient fully recovered from the emergency appendectomy. The patient file a lawsuit against the NP for malpractice and the outpatient clinic for inadequate supervision of the NP, claiming that a correct diagnosis would have prevented prolonged discomfort and emergency surgery, as well as loss of wages resulting from his presurgical and postsurgical care. You are an NP who has been hired as an expert witness and consultant by the insurance company representing the outpatient clinic. The attorney representing the NP has asked you to review the case and identify any concerns or further information that would help in resolving this case. Case Questions: 1. Because the NP is being accused of malpractice, you are asked to review the case to determine whether malpractice has occurred based on the required conditions. What are the three conditions that must exist to establish malpractice? 2. While reviewing the case file, you note that the insurance company is representing the clinic. If the clinic is determined to be “not guilty” of failing to provide adequate supervision of the NP, how could this affect the NP? 3. What should you seek to determine whether a breach of, or deviation from, the standard of care occurred, given the patient scenario of misdiagnosed appendicitis? Do you need additional information? 4. You have been asked to provide a written report of your review to be shared with the insurance company and the clinic as to whether you believe the NP has acted reasonably and if, in the same situation, you would have responded the same way. 5. What are some tips you could give the NP to avoid or reduce the possibility of legal issues?